Reducing call-to-needle times: the critical role of pre-hospital thrombolysis

J. A. L. Smith, K. P. Jennings, Eileen Anderson, P. Green, Graham Scott Hillis

    Research output: Contribution to journalArticle

    Abstract

    Background: Current guidelines recommend that patients with acute myocardial infarction should receive thrombolysis within 60 min of seeking professional help.

    Aim: To compare current rates of pre-hospital thrombolysis in Grampian with historical data, and assess the effect of pre-hospital thrombolysis on the proportion of patients achieving 'call-to-needle' times within national guidelines.

    Design: Prospective audit.

    Methods: Data were collected on all patients (n = 535) admitted to the coronary care unit and thrombolysed, either in hospital or in the community from July 2000 to June 2002, using standardized forms.

    Results: One hundred and thirty-three patients (25%) received pre-hospital thrombolysis and 402 (75%) received in-hospital thrombolysis. This compares with a 19% (195/1046) pre-hospital thrombolysis rate in the mid-1990s (p = 0.005). Median 'call-to-needle' times were 45 min for pre-hospital thrombolysis and 105 min for patients who received in-hospital thrombolysis (p < 0.001). Only 24% (96/396) of patients receiving in-hospital thrombolysis were treated within the recommended guideline, vs. 79% (88/111) of pre-hospital thrombolysis patients (p < 0.001).

    Discussion: Pre-hospital thrombolysis rates in Grampian are increasing. Administration of thrombolysis in the community greatly increases the proportion of patients achieving a 'call-to-needle' time of 60 min, with a median time saving of similar to1 h.

    Original languageEnglish
    Pages (from-to)655-661
    Number of pages6
    JournalQJM
    Volume97
    DOIs
    Publication statusPublished - 2004

    Keywords

    • ACUTE MYOCARDIAL-INFARCTION
    • EARLY ANISTREPLASE TRIAL
    • GENERAL-PRACTITIONERS
    • EUROPEAN-SOCIETY
    • TASK-FORCE
    • DOMICILIARY THROMBOLYSIS
    • FIBRINOLYTIC THERAPY
    • PRIMARY ANGIOPLASTY
    • RANDOMIZED TRIALS
    • MANAGEMENT

    Cite this

    Smith, J. A. L., Jennings, K. P., Anderson, E., Green, P., & Hillis, G. S. (2004). Reducing call-to-needle times: the critical role of pre-hospital thrombolysis. QJM, 97, 655-661. https://doi.org/10.1093/qjmed/hch111